Combining red yeast rice with low-dose statin for cholesterol management

Comparison Between Combined Therapy With Red Yeast Rice and Low-dose Statin and Standardized Statin: a Single-center, Non-inferiority, Randomized Clinical Trial

This study is testing if combining red yeast rice with a low dose of a cholesterol medication can help people with mild heart disease lower their cholesterol better and with fewer side effects than taking a higher dose of the medication alone.

Quick facts

• Phase: Phase 3
• Study type: Interventional
• Enrollment: 240 (estimated)
• Ages: 20 Years to 80 Years
• Sex: All
• Sponsor: Wenzhou Medical University (Academic / other)
• Locations: 1 site (Wenzhou, Zhejiang)
• Trial ID: NCT02726555 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the efficacy and safety of a combined therapy using red yeast rice and low-dose atorvastatin compared to a standard dose of atorvastatin in patients with mild atherosclerotic cardiovascular disease. Participants will be randomly assigned to receive either the combination therapy or atorvastatin alone for 24 weeks. The study will monitor lipid levels, medication adherence, and side effects through regular visits and laboratory tests. The goal is to determine if the combined therapy can effectively lower cholesterol levels with fewer side effects than higher doses of statins.

Who should consider this trial

Good fit: Ideal candidates are individuals with established mild atherosclerotic cardiovascular disease who are not currently on lipid-lowering medications.

Not a fit: Patients with severe cardiovascular disease or those currently taking lipid-lowering medications may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could provide a safer and more effective treatment option for patients with mild cardiovascular disease.

How similar studies have performed: Previous studies have suggested that red yeast rice may offer similar efficacy to statins with fewer side effects, indicating potential success for this combined approach.

Eligibility criteria

Inclusion Criteria:

1. Patients with established mild atherosclerotic cardiovascular disease, defined as coronary and/or carotid and/or peripheral artery lesions \<40% lumen diameter stenosis, diagnosed by coronary angiography and carotid and/or peripheral artery ultrasound respectively, together with LDL cholesterol level \> 70 mg/dL (1.80 mmol/L).
2. Female patients must be postmenopausal as defined by no menstruation for at least 12 months, or surgically sterilized for at least three months prior to beginning the study, or have a negative pregnancy test and agree to avoid pregnancy during the study and one month after the end of the study by using two reliable methods of contraception.
3. Patients must have been informed of all aspects of the study and signed an informed consent form before any study-related activities.
4. Patients must be willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.

Exclusion Criteria:

Patients who have met all the above inclusion criteria will be screened for the following exclusion criteria.

1. Patients who have been taken lipid-lowering medications including statins or red yeast rice products during the 4 weeks prior to the screening visit.
2. Documented history of myocardial infarction (MI), unstable angina leading to hospitalization, uncontrolled cardiac arrhythmia, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG), carotid surgery or stenting, cerebrovascular accident, transient ischemic attack, endovascular procedure or surgical intervention for peripheral vascular disease.
3. Planned to undergo scheduled PCI, CABG, carotid or peripheral revascularization during the study.
4. History of New York Heart Association Class III or IV heart failure within the past 12 months.
5. Known history of hemorrhagic stroke.
6. Patients with uncontrolled hypertension at the screening visit. Patients on stable antihypertensive medication may be enrolled provided that the medications and dosage remain stable throughout the study.
7. Cardiovascular surgery or major operations within 6 months prior to screening visit.
8. Patients who are taking anticoagulants except aspirin at \< 325 mg/day.
9. Patients with liver dysfunction as indicated by a serum alanine aminotransferase (ALT) or serum aspartate aminotransferase (AST) level of \> 1.5-times of upper limit of normal (ULN) range, or clinical symptoms.
10. Patients with elevated creatine phosphokinase level (above Upper Limit of Normal range).
11. Patients with renal dysfunction as indicated by a serum creatinine level above ULN range, or clinical symptoms.
12. Patients with gastric or peptic ulcer within 3 months prior to screening visit.
13. Patients with medical history of hypothyroidism, pancreatitis, cholestasis, nephrotic syndrome, gall bladder disease, or primary biliary cirrhosis. Patients on thyroid replacement therapy at stable doses may be enrolled if clinically euthyroid.
14. Patients with clinically relevant illness within 4 weeks prior to screening visit that may interfere with the conduct of this study.
15. Patients with a history of alcohol or narcotic substance abuse within two years prior to screening visit.
16. Patients with hypersensitivity to lipid-lowering agents.
17. Patients who have taken another investigational drug within 4 weeks prior to screening visit.
18. Patients with uncontrolled metabolic or endocrine disease knowing to influence lipid values.
19. Patients who are known to be HIV positive.
20. Patients who have a history or presence of active malignancy (other than non-melanoma skin cancer) or clinically significant psychiatric, neurological, respiratory, hematological, or other conditions that in the opinion of investigators might interfere with or contraindicate participation of the patients in this study.

Where this trial is running

Wenzhou, Zhejiang

• The Second Hispital of Wenzhou Medical University — Wenzhou, Zhejiang, China (Recruiting)

Study contacts

• Principal investigator: Kangting Ji, MD — The Second Hispital of Wenzhou Medical University
• Study coordinator: Kangting Ji, MD

Conditions Dyslipidemia; Atherosclerosis; Red yeast rice; Atorvastatin; Mild cardiovascular disease